Choosing a Birthplace and Caregiver

By Barbara Hanrahan – midwife and educator

Most women already have a gynaecologist by the time they fall pregnant. The question is do you know what you want from your birth experience? This is a sensitive area as your gynae may work at a hospital with limited birth options. So the first step is really to find out what YOU want and which setting will best offer you the birth options you are looking for.

1. Birthplace

Choosing the place of birth really determines the kind of birth choices you will have and who will be your caregiver.

  • A birth unit : this is a homely environment usually within a medical facility. A birth unit actively encourages partner and family participation. (Family centered maternity care.) The setting is relaxed and intimate. It may include a bath / jacuzzi / small pool, double bed and homely furniture. The caregiver could be your gynae or a private midwife. You have the option of going home shortly after the birth or staying for a couple of nights for help and guidance through those early days with your new baby. Birth units in a medical facility will have access to theatre should the need arise for a caesarean section.
  • A maternity ward  : this means that you would give birth in labour ward and then move to the postnatal ward for your postpartum stay. The choice of hospital is usually determined by the doctor, who may have consulting rooms at that hospital. This is a traditional hospital setting.
  • A homebirth : is usually attended by a pair of private midwives who will give you a lot of  guidance about what you need to prepare for the birth and what to expect on the day. You would attend regular antenatal checkups with these midwives. The midwives will arrange a back up doctor and hospital facilities in case of emergencies.

2. Caregiver

  • Private midwives are qualified, registered (with the SA Nursing Council) midwives who work independently in a self employed capacity. Midwives view pregnancy and birth as normal biological events and have a back up doctor should the need for intervention or a caesarean birth arise.
  • The doctor who looks after women in pregnancy is usually an obstetrician who has particularly specialised in the care of women who have a high risk in pregnancy.
  • Besides the midwife or doctor, many women are choosing to have a doula / birth companion present with them during labour and birth. A doula is a lay woman who has trained as a companion who supports women and their families during labour and birth. The doula can also provide care and support at home after birth too.
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